- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $5,128.61 / $10,232.93
| Facility | | $2,290.87 | $5,128.61 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $776.25 / $4,168.69
| Professional | | $501.19 | $776.25 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $2,187.76 / $3,090.30
| Professional | 50 | $724.44 | $2,187.76 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $407.38 / $524.81 / $4,168.69
| Professional | 54 | $407.38 | $524.81 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $38.02 / $95.50 / $851.14
| Professional | 55 | $38.02 | $95.50 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,570.88 / $7,079.46
| Facility | | $3,019.95 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,047.13 / $2,951.21
| Professional | | $630.96 | $1,047.13 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $1,584.89 / $4,365.16
| Professional | 50 | $933.25 | $1,584.89 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Facility | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Professional | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,698.24 / $2,691.53
| Facility | | $1,445.44 | $1,698.24 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,778.28 / $2,187.76
| Professional | | $794.33 | $1,778.28 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $5,888.44 / $10,471.29
| Facility | | $602.56 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,348.96 / $1,621.81
| Professional | | $1,000.00 | $1,348.96 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,513.56 / $2,041.74 / $2,398.83
| Professional | 50 | $1,513.56 | $2,041.74 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $794.33 / $1,071.52 / $1,288.25
| Professional | 54 | $794.33 | $1,071.52 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $199.53 / $269.15 / $323.59
| Professional | 55 | $199.53 | $269.15 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,801.89 / $7,244.36
| Facility | | $776.25 | $3,801.89 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,380.38 / $6,025.60
| Professional | | $630.96 | $1,380.38 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $741.31 / $758.58 / $4,365.16
| Professional | 54 | $741.31 | $758.58 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $83.18
| Professional | 55 | $38.90 | $38.90 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $5,754.40 / $7,762.47
| Facility | | $1,318.26 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,819.70 / $2,818.38
| Professional | | $676.08 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,096.48 / $1,698.24
| Professional | | $512.86 | $1,096.48 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,677.35 / $6,918.31 / $6,918.31
| Facility | | $4,677.35 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $933.25 / $1,380.38 / $1,380.38
| Facility | 53 | $933.25 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $3,235.94 / $4,786.30 / $4,786.30
| Facility | 54 | $3,235.94 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 55
- Typical Low / Median / Typical High
- $707.95 / $1,023.29 / $1,023.29
| Facility | 55 | $707.95 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,801.89 / $6,309.57
| Professional | | $1,000.00 | $3,801.89 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $2,511.89
| Professional | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $7,585.78 / $7,585.78
| Professional | | $2,884.03 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $6,760.83 / $9,120.11
| Facility | | $3,162.28 | $6,760.83 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $1,380.38 / $4,073.80
| Professional | | $93.33 | $1,380.38 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- 55
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Professional | 55 | $89.13 | $89.13 | $89.13 |